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Control of bacterial diseases

- New drugs and vaccines
Poultry CRC.
Queensland Alliance for Agriculture and Food
Innovation, University of Queensland
EcoSciences Precinct
GPO Box 267, Brisbane 4001 Australia
pblackall@poultrycrc.com.au

Introduction

The aim of this paper is take a fresh look at the

challenges that lie ahead in the prevention and
control of these diseases. The fact that the first
vaccine created by man was a fowl cholera vaccine
(Pasteur 1881) means that the microbiologists have
been working on bacterial respiratory diseases for
most of the history of the science of microbiology. It
is important that the achievements of the past 130
years are built upon so that emerging challenges in
terms of the control of these diseases can be met
and overcome.

Antibiotics and Antibiotic resistance

There are two quite different issues that present
future challenges in this area.
In developed countries such as Australia, there
is now considerable pressure to reduce the use of
antibiotics in poultry production. This pressure to
reduce antibiotic useage is not necessarily arising

This general low level of antimicrobial resistance

in poultry associated bacteria in Australia has
also been confirmed in a national survey of
Campylobacter (132 isolates), Enterococcus
faecalis (123 isolates) and E. coli (269 isolates)
obtained from 13 processing plants (DAFF 2007).
Resistance was absent (or less than 5% prevalence)
in the E. coli isolates for cefotaxime, ceftiofur,
chloramphenicol,
ciprofloxacin,
florfenicol,
gentamicin and naladixic acid. Resistance was
detected to ampicillin (33%), tetracycline (44%)
and trimethoprim/sulfamethoxazole (27%) (DAFF
2007). The E. faecalis isolares showed no resistance
to ampicillin, gentamicin, teicoplanin or vancomycin
but did have marked resistance to erythromycin
(77%) and virginiamycin (93%) (DAFF 2007). As E.
faecalis has intrinsic resistance to streptogramins
such as virginiamycin (Yoshimura et al., 2000), the
only resistance of any note found in these E. faecalis
isolates is the resistance to erythromycin (DAFF
2007).

P.J. Blackall

acterial diseases in poultry are caused by a vast

range of bacteria with typical pathogens being
Avibacterium paragallinarum, Clostridium
perfringens, Escherichia coli, Pasteurella
multocida, Salmonella spp. and Staphylococcus
aureus. In addition, there are food safety bacterial
pathogens to consider the major ones being
Campylobacter and Salmonella spp. These
diseases fail to attract the media attention and the
headlines given to prominent viral infections such
as avian influenza and exotic Newcastle disease.
Nevertheless, bacterial diseases continue to remain
a problem in productions system based in both the
developing world as well as the developed world.

because of the existence of high levels of antibiotic

resistant bacteria. Australia is an example of a
country where there is considerable consumer
concerns about antibiotics and hence a level of
regulatory pressure to reduce antibiotic use. Yet,
all evidence to date is that antibiotic resistance in
Australian poultry-associated bacteria is quite low.
Indeed, Australian poultry isolates of Campylobacter
jejuni/coli (125 and 27 respectively examined) were
universally susceptible to ciprofloxacin and naladixic
acid in an MIC based study (Miflin et al., 2007). No
resistance to erythromycin was detected in the C.
jejuni isolates while three isolates of C. coli were
resistant to this antibiotic. Miflin et al., (2007) found
universal sensitivity to chloramphenicol and only
low levels of resistance (<20%) to ampicillin and
tetracycline and found no isolate to have multiple
resistance (resistant to more than three different
classes of antibiotics).

The other interesting data on antimicrobial

resistance and Australian poultry isolates concerns
the causative agent of infectious coryza Av.
paragallinarum. The available data indicates that
Australian isolates of Av. paragallinarum show little
evidence of antibiotic resistance (Blackall 1988).
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P.J. Blackall

Indeed, 55 of 75 isolates showed no resistance at

all to any of the six antibiotics tested with the only
notable resistance detected being that 20 isolates
were resistant to streptomycin (Blackall, 1988).
Hence, there is a body of evidence of minimal
antibiotic resistance in both poultry bacterial
pathogens and bacteria that are part of the
normal gut flora in Australian poultry. However,
the regulatory pressures in Australia are such that,
effectively, only two antibiotics (chlortetracycline
and linco-spectin) are permitted for prophylactic or
therapeutic use in laying hens (Grimes, 2004). This
means that the there is considerable pressure to
develop alternative prevention and control measures
based on effective vaccines and novel green
antimicrobial compounds. Hence, in countries
such as Australia, there is a considerable national
research program focussed on these alternative
prevention and control programs. These programs
are described in full at the Websites of the major
bodies funding poultry research in Australia the
Poultry CRC (https://www.poultrycrc.com.au/index.
php), the Chicken Meat Research and Development
Committee within the Rural Industries Research
and Development Corporation (http://www.rirdc.
gov.au/programs/cm.html) and the Australian Egg
Corporation Limited (http://www.aecl.org/). In
countries such as Australia, the future challenges
quite clearly include the need to develop prevention
and control programs that do not feature reliance
upon antibiotics despite the relative absence of
antibiotic resistance.
Another example of developed countries such as
those in the European Union and the concern about
antibiotic resistance is the on-going debate about
the use of fluoroquinolones in veterinary medicine
(de Jong et al., 2012). While the debate will no
doubt range for some time, the available evidence is
that the level of ciprofloxacin resistance in European
avian isolates of E. coli and Salmonella is low
around 6% in E. coli in 563 isolates and absent in
the 71 Salmonella isolates (de Jong et al., 2012).
While the absolute levels of fluorquinolone
resistance are an important tissue, the debate on
fluoroquinolone resistance also involves the issue
of bacteria which are technically still sensitive to an
antibiotic but which show decreased susceptibility.
This sub-population showing decreased susceptibility
can be recognised by the use of testing interpretation
criteria that based on epidemiological values and not
the therapy based criteria that are commonly used
(de Jong et al., 2012). The European Committee on
Antimicrobial Susceptibility testing (EUCAST) has

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recently set these epidemiological cut-off values for

a range of antibiotics (see http://www.eucast.org).
While for many antibiotics the difference between
the clinical therapy criterion for resistance and the
epidemiological cut-off value are often identical or
differ only a one or two dilutions, this is not the
case for the fluoroquinolones. For ciprofloxacin, the
EUCAST MIC for resistance, based on the therapy
approach, is >4 g/ml while the epidemiological
cut-off value is less than <0.06 g/ml.
Using the epidemiological cut-off value,
European isolates of avian E. coli have shown a level
of decreased susceptibility to ciprofloxacin that has
risen from 19.3% in 1999-2000 to 33.5% in 20052006 (de Jong et al., 2012). For avian Salmonella, the
percentage of the population showing decreased
susceptibility to ciprofloxacin has risen from 26.7%
in 1999-2000 to 47.9% in 2005-2006 (de Jong et
al., 2012).
Hence, while there are often no frank resistance
problems in developing countries, there continues
to be increasing regulatory and consumer pressure
to reduce or remove antibiotics from poultry
production systems.
In the developing countries, the challenge of the
future is more focussed on the need to address the
problem of frank antibiotic resistance in the bacteria
associated with respiratory disease. As an example,
Hsu et al., (2007) have reported that around 89%
of isolates of Av. paragallinarum from Taiwan are
resistant to two or more antibiotics. As well, the
same authors have reported the presence of the
multi-drug-resistant plasmid pYMH5, suggesting
the possibility of the spread of antibiotic resistance
amongst Av. paragallinarum isolates (Hsu et al.,
2007). Clearly, the future challenges for control of
bacterial respiratory diseases in such settings require
an ability to develop effective control programs that
are less reliant upon antibiotics.
Hence, while coming from different perspectives,
the reality is that the poultry industries of both the
developing and the developed world have a need
for future research to feature a strong emphasis
on prevention and control programs that do not
require the prolonged use of antibiotics.

Alternatives to antibiotics - Probiotics

While there are now a range of emerging
alternatives to antibiotics, perhaps one of the oldest
alternatives probiotics is gaining increased
scientific interest. Probiotics can be defined as live
micro-organisms which when given in adequate

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amounts confer a health benefit on the host

(Tellez et al., 2011). The original mechanism of
action of probiotics was thought to be competitive
exclusion (Nurmi and Rantella 1973). There is now
an understanding that other mechanisms to explain
the activity of probiotics exist - stimulation of both
innate (Farnell et al., 2006) and humoral immunity
(Leblanc et al., 2004), immune regulation (Li et al.,
2009) and even possibly increased apoptosis (Higgins
et al., 2011). While not universally accepted in all
parts of the world, there is now considerable uptake
of the use of commercial probiotics for the control
of Salmonella in the USA (Tellez et al., 2011).

Alternatives to antibiotics - Bacteriophages

For some time now, there has been active
research into the use of bacteriophages to control
bacterial diseases of poultry (Johnson et al., 2008).
In a critical overview of the literature, Johnson et
al., (2008) conclude that phage administration via
aerosol might achieve levels in the respiratory tract
that can prevent colibacillosis but not the levels
required for treatment. Treatment levels require
intra-muscular injection (Johnson et al., 2008), an
option that is not viable in the broiler industry. This
suggests that phage therapy for coli-bacillosis has
the greatest potential as a preventative measure and
not a treatment tool. In terms of Salmonella, the
results achieved with phage have been very mixed.
Reports of significant reductions in Salmonella levels
following phage treatment (Atterbury et al., 2007)
can be matched by studies that reports of transient
reductions only (Andreatti Filho et al., 2007). At
this stage, it would appear that phage control of
Salmonella is some distance away yet.

Alternatives to antibiotics Natural

feed additives
There is a vast and expanding literature on the
search for and evaluation of a range of natural
additives that can be used in place of antibiotics.
For the purpose of this review, the literature dealing
with the possible use of caprylic acid as a natural
feed additive to control Campylobacter has been
selected.
Fatty acids - especially medium-chain fatty acids
have been long known to have antimicrobial activity
against a range of micro-organisms (Bergsson et
al., 1998) Researchers at the University of Arkansas
selected caprylic acid (a medium-chain fatty acid
with 8 carbons) as a potential natural feed additive
(Solis de Los Santos et al., 2008a). The selection of
this acid was based on the knowledge that caprylic
acid is likely to be regarded by most regulatory
authorities as an acceptable and natural feed
additive for poultry. Several lines of evidence support
this belief. Firstly, caprylic acid is naturally found in
human breast milk (Jensen et al., 1990). When used
as a food-grade compound, caprylic acid is generally
regarded as safe (GRAS) by the US Food and Drug
Administration (Solis de Los Santos et al., 2008a).

P.J. Blackall

A growing area of interest is the concept of

the use of probiotics to improve reproductive tract
health. In preliminary studies performed in Australia,
treatment with two different probiotics for 4 weeks
(from 18 to 22 weeks of age) in the drinking water
significantly reduced the occurrence of reproductive
tract pathologies, reduced cumulative mortality
and increased performance (egg production, egg
weight and BW) of laying hens, during and in the
subsequent period (i.e. for a further 20 weeks)
post-treatments (Shini and Blackall 2009). More
research and field trials are needed to establish the
efficacy of probiotics and confirm subtle changes
in the levels of beneficial bacteria in the intestinal
and reproductive tracts of hens. Overall, the data
from the Australian study has suggested that the
probiotics may be able to increase the resistance of
laying hens to reproductive infections and improve
their liveability.

In contrast, phage therapy for the control

of Campylobacter in broilers holds considerable
promise. Several studies (Atterbury et al., 2005;
Wagenaar et al., 2005; Atterbury et al., 2007) have
reported significant reductions in Campylobacter
levels in treated chickens. There is considerable
interest in the concept of the use of phages as a preharvest treatment in which different lytic phages are
rotated across different production cycles (Johnson
et al., 2008). Despite this promise, key issues phage
dose, phage-resistance, phage-host combinations
remain to be addressed (Johnson et al., 2008).

In the initial work of the Arkansas group, the

use of caprylic acid at a dose of 0.7% in feed
consistently reduced caecal Campylobacter counts
in a young chick model (Solis de Los Santos et al.,
2008a). If used at a higher dose level (1.4%), there
was a reduced feed consumption and body weight
(Solis de Los Santos et al., 2008a).
In subsequent work, the University of Arkansas
group has shown that the feed supplementation with
caprylic acid at 0.35% and 0.7% can consistently
decrease the caecal levels of Campylobacter in
market-age broilers (Solis de Los Santos et al.,
2008b). When used with a 12 hour feed withdrawal
program, the feed supplementation with caprylic
acid had to be at the 0.7% to achieve a significant
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XXIV
Campylobacter reduction (Solis de Los Santos et
al., 2008b). These reductions were of the order
of 2 to 3 log reductions in 3 day and 7 day feed
supplementation experiments.
The challenge for these natural additives such
as caprylic acid is to move beyond the world of the
poultry research science groups. The data for caprylic
acid is quite convincing but the practical application
(including how to organise supplemented feed in
multiple pick up scenarios) remains to be addressed.

Novel Vaccines Fowl Cholera

P.J. Blackall

Given that the one of first ever vaccines was the

fowl cholera vaccine developed by Louis Pasteur, it is
appropriate to look at fowl cholera vaccines past,
present and future as an example of the potential
for novel bacterial vaccines for poultry.
In many parts of the world, the only vaccines
available for fowl cholera have been killed vaccines
either autogenous or based on the three most
common somatic serovars associated with fowl
cholera (serovars 1, 3 and 4) (Glisson et al., 2008).
In the USA, live vaccines (the original CU strain or
mutants created from the CU strain) have also been
used. It is recognised that these CU-type live vaccines
have been associated with mortality problems in
vaccinated birds (Glisson et al., 2008).
Now, some 100 years after the original fowl
cholera vaccine, the advances in molecular biology
have opened up new possibilities of fowl cholera
vaccines that are based on strains that have
been rationally attenuated. As an example, there
have been on-going sophisticated and detailed
molecular studies, based at the Monash University
and collaborators at a number of institutes around
the world. While much of the early work was on
haemorrhagic septicaemia (Ramdani et al., 1990),
the focus of the recent work has been fowl cholera
(Harper et al., 2006).
In an early study, Homchampa et al., (1992)
created a mutant of P. multocida in which a key
gene associated with the ability of the organism to
grow (in vitro and in vivo) was disabled. Efficacy of
this approach of producing a rationally attenuated
live vaccine was shown in mice (Homchampa et al.,
1992). This work then enabled the development of
two aroA mutants (one in a serovar 1 isolate and
another in a serovar 3 isolate) which were both
shown to provide cross-protection in vaccinated
chicken against a serovar 4 challenge (Scott et al.,
1999). These early studies have recently culminated
in the release of the commercial fowl cholera vaccine

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based on a serovar 1 strain with an aroA deletion

(http://www.bioproperties.com.au/vaccines/
VaxsafePM.htm). This vaccine is an example of
research work in basic molecular biology that has
delivered a commercial product. While produced via
genetic engineering, the final vaccine strain is free of
any extraneous DNA and is not regarded as a GMO
in the Australian market (http://www.bioproperties.
com.au/vaccines/VaxsafePM.htm).
Novel Vaccines Campylobacter and
Clostridium perfringens
There are two other bacterial agents for which
there is considerable hope at the moment for
novel vaccines Campylobacter and Clostridium
perfringens. In both cases, the bacterial agent
involved can be argued (with considerable
justification) as being part of the normal flora of
the chicken. This concept of producing a vaccine
effective against a normal flora component ads
another layer of difficulty.
The interest in vaccines for the control of
necrotic enteritis (caused by Cl. perfringens)
arises from increasing concerns that the current
successful control strategies are based on routine
prophylactic administration of antibiotics may
not be acceptable to consumers/regulators in the
future (Crouch et al., 2010). A commercial necrotic
enteritis vaccine is now available in many parts of
the world. This commercial product is based on a
cell-free supernatant toxoid vaccine which is given
to breeders. Field trials have shown that this vaccine
can result in a significant reduction in mortality
and in the typical lesions of necrotic enteritis
(Crouch et al., 2010). An alternative approach is
being developed by researchers in Australia. The
Australian research group has identified a novel
toxin (the NetB toxin) which they claim is crucial for
the induction of necrotic enteritis (Keyburn et al.,
2008). Whether this novel toxin can form the basis
of new generation necrotic enteritis vaccine is now
the basis on current on-going research in the Poultry
CRC in Australia.
Interest in vaccines for Campylobacter for
meat chickens is driven by the recognition that
Campylobacter is a major cause of human causing
an estimated 400 million cases of enterocolitis
per year around the world (de Zoete et al., 2007).
While not the only source of Campylobacter,
poultry meat is regarded as a major source of
human exposure to Campylobacter (Zhang 2008).
To date, there are no commercial vaccines for the
control of Campylobacter in chickens (Zhang 2008).
However, there is considerable interest and hope

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in such vaccines. In part, the interest arises from

the fact that significant improvements in human
health are possible by reducing, but not necessarily
eliminating, Campylobacter in chickens. Using
models, it has been shown that a 2 log reduction in
faecal Campylobacter counts would reduce human
infections associated with chicken meat by 75%
while a 1 log reduction in faecal counts and a 1 log
reduction in the processing plant would achieve a
90% reduction (Havelaar et al., 2007). Hence, the
interest in vaccines to achieve a reduction in faecal
levels of Campylobacter.
Again, the brightest potential is showing in
experimental vaccines produced by molecular
biology. Several studies have shown that liveattenuated Salmonella vaccines that express
Campylobacter antigens have the capacity to reduce
caecal levels of Campylobacter (Wyszynska et al.,
2004; Buckley et al., 2010). While the research
results to date have been promising, key challenges
remain A) the need for cross-protective antigens
to provide as broad a protection as possible for this
diverse bacterium and B) the need for rapid, strong
and immune response (de Zoete et al., 2007).

There is no doubt that communities around

the world suffer a significant cost impost due to
the effects of Campylobacter on the population.
However, significant controls at the consumer
and food preparation level exist. Through cooking
and good basic food and personal hygiene are
universally accepted as major control points. In this
light, it can be a difficult argument to conclude
that the chicken meat industry must use a vaccine
to reduce Campylobacter levels. To our knowledge
colonisation of chickens by Campylobacter is normal
and has no adverse impacts on the chicken. Hence,
the industry may be in a situation where it is asked
to bear the cost of vaccine that has no impact on
production parameters but is being used to achieve
food safety outcomes that cannot be reliably
achieved at the consumer and food handler level. If
future food safety vaccines are multivalent vaccines
that confer protection against multiple food safety
pathogens (Campylobacter and Salmonella) as well
as true poultry pathogens (e.g. avian pathogenic E.
coli), the cost argument will be less of a contentious
issue.

The clear challenge for the future is to take the

insights and detailed knowledge now being gained
by research teams such as those described above
(in areas diverse as probiotics and immunology) and
produce new generation prevention and control
products (phages, probiotics, vaccines, natural
fed additives) for a range of bacterial diseases
and bacterial food safety pathogens. These new
generation products are required in an intensive
industry that is acutely cost conscious and market
focussed. At the same time, the poultry industry
while having a very similar nature in terms of
technical issues across the world operates in
regulatory markets that are markedly different.
Hence, as an example, a new vaccine based on a
genetically modified organism may be a perfectly
acceptable product in one market BUT may be
totally unacceptable in another market.

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XXIV

Worlds Poultry Congress 5 - 9

August - 2012 Salvador - Bahia - Brazil

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P.J. Blackall
Area: Poultry Health and Biosecurity August 06